Senior Finance Manager – Payer Strategy & Analytics

🕒 il y a 1 jour

🏈 Ohio – Distant

🏈 Ohio – Remote

💵 $103 887 - $192 191 / an

⏰ Temps Plein

🟠 Senior

💸 Planification et Analyse Financières (FP&A)

👻 Score fantôme 0%

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US Acute Care Solutions

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2015

🏥 Santé

💊 Pharmaceutique

📡 Télécommunications

💰 Private Equity Round en 2021-02

Healthcare • Pharmaceuticals • Telecommunications

US Acute Care Solutions est une société détenue par des médecins, spécialisée dans la gestion et la fourniture de services de soins aigus à travers les États-Unis. En se concentrant sur la médecine d'urgence, la médecine hospitalière et les soins critiques, USACS s'associe aux systèmes de santé pour améliorer les soins aux patients et optimiser le continuum des soins de santé. Chaque année, l'entreprise dessert plus de 10 millions de patients et gère plus de 500 programmes cliniques dans 30 États, animée par un engagement en faveur de l'innovation, de la qualité et de la collaboration dans la prestation des soins de santé.

Description

• Serve as the key analytical partner to Payor Contracting, Revenue Cycle/AR Follow-Up, Legal, Finance, Accounting, and Operations on reimbursement strategy • Build financial models and recommendations for payor contract negotiations, renewals, and terminations • Quantify in-network versus out-of-network scenarios by payor and market • Ensure revenue recognition, budgets, and forecasts reflect expected IDR, arbitration, and litigation outcomes • Own analytics for federal No Surprises Act IDR and state arbitration programs • Track dispute volume, eligibility, filing deadlines, cycle time, win/loss rates, award amounts, and return on dispute cost • Analyze CMS federal IDR Public Use Files and internal IDR determination data • Evaluate IDRE selection and determination patterns and recommend selection and objection strategies • Develop offer and rate strategies for IDR and arbitration submissions • Analyze and report payor contract performance, yield, rate benchmarks, escalators, and underpayments • Partner with AR Follow-Up and Revenue Cycle leaders to prioritize work queues and optimize dispute timing • Provide data analysis, underpayment and damages modeling, and exhibits for payor litigation and award enforcement • Monitor regulatory, legal, and industry developments and communicate business impact • Perform diligence revenue reviews of potential payor contracts and acquisitions • Design and maintain dashboards, performance metrics, and ad-hoc analyses • Develop analytics and data collection standards to ensure dispute, claims, and contract data integrity • Perform other duties as needed

🎯 Exigences

• Bachelor’s degree in Business, Finance/Accounting, Economics, Health Policy, Informatics, or a related field, or equivalent experience (MBA or master’s preferred) • At least 5 years of reporting, analytics, and business operations experience, preferably in the healthcare/provider space • At least 2 years of direct experience in payor contracting analytics, out-of-network reimbursement, or No Surprises Act IDR/state arbitration analytics • At least 2-3 years of leadership experience • Working knowledge of the No Surprises Act, the federal IDR process, the qualifying payment amount (QPA), and state surprise billing and arbitration frameworks • Ability to analyze large public and proprietary data sets and translate findings into clear strategy recommendations • Strong understanding of payor contracting, fee schedules, claims adjudication, remittance and EOB data, and emergency medicine professional billing and coding • Strong financial acumen and advanced analytical skills, including benchmarking, forecasting, and scenario and sensitivity modeling • Advanced Excel, PowerPivot, and a business intelligence tool such as Power BI or Tableau • Experience with SQL, Python, or R preferred • Strong business acumen and interpersonal skills • Excellent oral and written communication and presentation skills • Sound judgment in handling confidential, privileged, and protected health information • Ability to manage complex projects and achieve department goals • Superior time management, organizational, and problem-solving skills • Preferred: experience with emergency medicine or other hospital-based physician groups, and experience supporting litigation or arbitration with Legal and outside counsel • Ability to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds • Close visual acuity required • U.S. work location indicated by “Virtual USA”

🏖️ Avantages

• Medical, dental, and vision insurance options • Health savings accounts (HSA) and flexible spending accounts (FSA) • 401(k) employee and employer contributions • Paid time off, including vacation, sick leave, and company holidays • Paid parental leave & family support benefits • Short-term and long-term disability insurance • Life and accidental death & dismemberment (AD&D) insurance • Employee assistance programs & wellness resources • Bonus eligibility, equity, or other incentive programs, depending on the role

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